A guardian of the person makes personal decisions for someone who cannot make them independently. This includes healthcare choices, living arrangements, daily care, and other non-financial matters affecting the ward's wellbeing. Being guardian of the person means responsibility for another human's quality of life—a role requiring compassion, judgment, and dedication.
Personal guardianship differs from financial guardianship (guardian of the estate). Some guardians hold both roles; others are appointed only for personal matters while someone else handles finances.
Decisions the Guardian Makes
The guardian of the person typically has authority over healthcare decisions, including consenting to medical treatment, choosing doctors and hospitals, making end-of-life care decisions, and managing medications. Healthcare guardianship may include decisions about surgery, hospitalization, and life-sustaining treatment.
Living arrangement decisions fall under personal guardianship: where the ward lives, whether in their own home, with family, in assisted living, or in a nursing home. The guardian balances safety, care needs, ward preferences, and practical constraints.
Daily life decisions include diet, clothing, activities, visitors, religious practice, and social engagement. Good guardians preserve the ward's autonomy wherever possible, involving them in decisions even when they cannot make choices independently.
Best Interest Standard
Guardians must act in the ward's best interest, not their own convenience or preference. This means considering what the ward would want if they could decide, not just what seems easiest or cheapest.
When the ward previously expressed preferences—about care, living situations, or treatment—the guardian should honor those wishes unless circumstances make it impossible. Someone who always said "I never want to go to a nursing home" may still need nursing-level care, but the guardian should exhaust alternatives first.
The guardian must also consider the ward's current expressed preferences, even if they're inconsistent or seem unwise. A person with dementia who wants ice cream for dinner isn't making good nutritional choices, but occasional indulgence respects their humanity.
Healthcare Decision-Making
Medical decisions present some of the hardest challenges. The guardian receives medical information, consults with doctors, and makes treatment decisions. For major procedures or treatments with significant risks, guardians should seek second opinions and consider whether the ward would have wanted the intervention.
End-of-life decisions are particularly weighty. Deciding to continue or withdraw life support, whether to pursue aggressive treatment or comfort care, and managing pain while considering quality of life require careful thought. Some courts require specific authorization for life-or-death decisions.
Mental health treatment decisions—psychiatric hospitalization, psychotropic medications, electroconvulsive therapy—often have special rules. Some jurisdictions require court approval for certain psychiatric interventions even when a guardian has general healthcare authority.
Living Arrangement Decisions
Choosing where the ward lives involves balancing safety, care needs, cost, and quality of life. Courts generally prefer the least restrictive setting that meets the ward's needs. Someone who needs help with meals doesn't necessarily need a nursing home if home care can provide adequate support.
Moving someone from their home—especially to institutional care—is traumatic. Guardians should involve the ward in discussions, visit potential facilities together if possible, and make transitions as gentle as circumstances allow.
Some guardianship orders require court approval before placing the ward in a nursing facility or other institutional setting. Check your specific guardianship terms for any required permissions.
Ongoing Responsibilities
Personal guardians have continuing duties beyond major decisions. Regular visits ensure the ward receives proper care. Courts typically require guardians to file annual reports describing the ward's condition, living situation, and care received.
Guardians should monitor care quality, advocate with healthcare providers, maintain relationships with the ward, and adjust care plans as needs change. This is active, ongoing responsibility—not a one-time appointment you can then ignore.
If you can no longer serve effectively—due to your own health, relocation, or changed circumstances—you must petition the court to appoint a successor guardian. You cannot simply stop being guardian.
When Personal and Financial Guardians Differ
When different people serve as guardian of the person and guardian of the estate, coordination is essential. Personal care decisions often have financial implications—nursing homes cost money, medications cost money, home modifications cost money.
The personal guardian makes care decisions; the financial guardian must fund them. Disagreements may require court resolution. Clear communication and shared commitment to the ward's welfare help prevent conflicts.
Getting Legal Help
Becoming guardian of the person involves court processes and ongoing legal obligations. An attorney helps you understand your authority and limits, navigate required reporting, address complications, and ensure you're fulfilling your duties properly. When facing difficult healthcare or placement decisions, legal guidance helps you act appropriately while protecting both the ward's interests and your position as guardian.